Industry Voices—Are Medicare insurers ready for the digital future?

Medicare enrollment form
It’s clear that the industry has to do better as Medicare beneficiaries seek to navigate their way in the digital age. (Getty/zimmytws)

A Medicare beneficiary who quickly gets intimidated by most technology tools comes to your website hoping to learn about your Medicare offerings. Unfortunately, instead of getting answers, she winds up frustrated and confused and then leaves to find a competitor with a frictionless shopping experience.

But, why did she get frustrated and leave? Was the website running too slowly? Was the user experience not intuitive? Was there no easy way to understand which plans cover her preferred doctors or prescriptions?

These questions should not arise in the second decade of the 21st century as seniors become more technologically savvy and expect more from their health plan. Research finds that 42% of them prefer to shop for coverage online, and this trend places pressure on health plans to keep up with the forces of digital transformation reshaping the industry.

It’s clear that the industry has to do better as Medicare beneficiaries seek to navigate their way in the digital age. There is increasing demand being put on the system, but while healthcare providers have accepted the concept of digital transformation, many still struggle to figure out how to make more efficient use of these new technologies.

RELATED: CMS unveils app for Medicare beneficiaries to view coverage details

Consider some of the results of a recent study that Harvard Business Review Analytic Services conducted, looking into the overall state of healthcare technology:

  • 53% of organizations take many months to more than a year to integrate changes and updates into business processes and systems.

  • 62% of organizations report between two and 10 different software systems are involved when handling customer issues such as providing quotes or enrolling new subscribers.    

  • 43% of respondents lacked the change management processes necessary to effectively implement new digital technologies.

Technology ought to be a boon to beneficiaries, who need decision guidance based on their choice of doctors, current medications and risk profile. When they need more information, they should be able to easily book appointments with an agent or attend an educational seminar to get plan-related advice.

To be sure, health insurers have a vested interest in embracing change and driving digital transformation. After all, the organizations that lead are likely to be the ones that emerge as clear winners in the growing Medicare Advantage marketplace.

RELATED: Beneficiaries may benefit from tech support tools when choosing Part D plans, study finds

However, when it comes to Medicare digital readiness, our own survey of the leading health insurers in the U.S. found that while some companies did better than others, there was significant room for improvement everywhere:

  • When beneficiaries come to your site, anything less than crisp response time can spell failure. Yet more than 80% of the plans we reviewed took more than three seconds to respond. This is suboptimal and likely to adversely impact conversion rates.

  • A multilingual website is another capability that increases penetration into new markets. Yet, nearly 50% of the plans reviewed only provide English language instructions. The fact that health plans aren't prepared for a growing, diverse and aging population is an inevitable obstacle. For example, in 2010, Hispanic adults constituted 6.9% of the population 65 and over. By 2050, the U.S. Census Bureau projects that Hispanics will represent 18.4% of the older population, which will likely be reflected by similar growth in its share of the Medicare population. Given that approximately 41 million people in the U.S. speak Spanish only, that’s an opportunity.

  • Decision guidance is a must. Beneficiaries expect an intelligent and streamlined workflow that helps them navigate a website and enhances their buying experience. But, our examination found that more than 65% of the healthcare websites reviewed are saddled by long, complicated plan selection and enrollment workflows. This increases the risk that frustrated beneficiaries will simply give up and abandon the process.

  • Proactively seeking and capturing feedback is another best practice that can help improve online member experience by creating positive sentiments and making them feel associated with the plan. Yet, more than 60% of the plans fail to solicit feedback.

  • With beneficiaries’ increasing preference for social channels, plans need to offer support through these channels as well. However, our assessment found that less than 20% of the plans provide customer support via social media channels.

Staying ahead of digital disruption

Not surprisingly, these factors are leading to rapid-fire changes in the Medicare space. Centene's proposed $17 billion acquisition of WellCare will result in a combined company with 22 million members in all 50 states and total revenue close to $100 billion. And last year, CVS Health acquired health insurer Aetna for $70 billion. At the same time, there are renewed calls for single-payer healthcare in the U.S., a topic likely to invite more discussion as the 2020 primary race gets underway.

RELATED: UnitedHealthcare expands digital data collection for Medicare beneficiaries

All of this puts an increased onus on organizations to better engage with prospects and customers. Beneficiaries are increasingly thriving in a digital world, and they have set expectations of simplified and tailored experiences when they head to a website to browse, bank or buy products and services. The same expectations apply when they log on to their healthcare providers’ websites.

The good news is that digital transformation is not “mission impossible”—and the organizations that are furthest along in terms of digital maturity are seeing average Net Promoter Scores that are 17 points higher than the less-mature digital plans.

Organizations can reach the top rungs of their field and become best-in-class by following the recommendations laid out in Vlocity Health’s digital assessment reports, which are measured against 48 best practices. 

  • Provide key missing capabilities like self-service, support and procedure cost estimation through mobile apps.

  • Implement an omnichannel strategy that enables seniors to easily navigate digital interactions and connects them with offline experiences as well.

  • Build other best practices, like advanced search options and guided navigation. The goal ought to be better comparison tools to help patients check whether their preferred doctor and prescription drugs are covered by their plans.

  • Offer formal quotes via email, click to call or click to chat, provider ratings and reviews to enhance the overall member experience.

There’s no reason to get left behind as the digital revolution gathers pace. But plans need to formulate a clear digital strategy and engage the right partners to bridge the gap between their existing digital readiness and best in class capabilities to drive better business results.  

Kevin Riley is the senior vice president of health at Vlocity, an industry-specific cloud and mobile software platform.